Prolonged remission in systemic lupus erythematosus rare but more likely in milder disease

Prolonged clinical remission in systemic lupus erythematosus is a rare occurrence, but is more likely to occur in individuals with milder earlier disease who have had less need for corticosteroid and/or immunosuppressive treatment, and therefore less damage, according to data from an observational case-control cohort study.

The study of 1613 patients with systemic lupus erythematosus (SLE) found 38 (2.4%) achieved prolonged remission – defined as Systemic Lupus Erythematosus Disease Activity Index of 0, 2, or 4 for at least 5 consecutive years – while not taking corticosteroids or immunosuppressives, as reported in a paper published online August 1 in The Journal of Rheumatology [doi:10.3899/jrheum.131137].

Mean time to remission from clinic entry was 9.1 years, patients achieved remission for an average of 11.5 years, and those who achieved remission had experienced fewer skin, central nervous system, and pulmonary manifestations, and had accrued significantly less organ damage than those who did not achieve remission.

"There was no difference in antimalarial use between groups, but overall prednisone use and cumulative dose was significantly lower among cases at the start of their prolonged remission period, as was the use of immunosuppressive agents," wrote Dr. Amanda J. Steiman and colleagues from the University of Toronto Lupus Clinic.

There were no conflicts of interest declared.

Prolonged clinical remission in systemic lupus erythematosus is a rare occurrence, but is more likely to occur in individuals with milder earlier disease who have had less need for corticosteroid and/or immunosuppressive treatment, and therefore less damage, according to data from an observational case-control cohort study.

The study of 1613 patients with systemic lupus erythematosus (SLE) found 38 (2.4%) achieved prolonged remission – defined as Systemic Lupus Erythematosus Disease Activity Index of 0, 2, or 4 for at least 5 consecutive years – while not taking corticosteroids or immunosuppressives, as reported in a paper published online August 1 in The Journal of Rheumatology [doi:10.3899/jrheum.131137].

Mean time to remission from clinic entry was 9.1 years, patients achieved remission for an average of 11.5 years, and those who achieved remission had experienced fewer skin, central nervous system, and pulmonary manifestations, and had accrued significantly less organ damage than those who did not achieve remission.

"There was no difference in antimalarial use between groups, but overall prednisone use and cumulative dose was significantly lower among cases at the start of their prolonged remission period, as was the use of immunosuppressive agents," wrote Dr. Amanda J. Steiman and colleagues from the University of Toronto Lupus Clinic.

There were no conflicts of interest declared.

Prolonged clinical remission in systemic lupus erythematosus is a rare occurrence, but is more likely to occur in individuals with milder earlier disease who have had less need for corticosteroid and/or immunosuppressive treatment, and therefore less damage, according to data from an observational case-control cohort study.

The study of 1613 patients with systemic lupus erythematosus (SLE) found 38 (2.4%) achieved prolonged remission – defined as Systemic Lupus Erythematosus Disease Activity Index of 0, 2, or 4 for at least 5 consecutive years – while not taking corticosteroids or immunosuppressives, as reported in a paper published online August 1 in The Journal of Rheumatology [doi:10.3899/jrheum.131137].

Mean time to remission from clinic entry was 9.1 years, patients achieved remission for an average of 11.5 years, and those who achieved remission had experienced fewer skin, central nervous system, and pulmonary manifestations, and had accrued significantly less organ damage than those who did not achieve remission.

"There was no difference in antimalarial use between groups, but overall prednisone use and cumulative dose was significantly lower among cases at the start of their prolonged remission period, as was the use of immunosuppressive agents," wrote Dr. Amanda J. Steiman and colleagues from the University of Toronto Lupus Clinic.

There were no conflicts of interest declared.